Individual provider Active NPI

Taz Thomas, P.A.

  • Physician Assistant
  • Kingwood, TX
National Provider Identifier
1629080569
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00733 Issued in TX
Practice address
22999 Highway 59 N
Suite 272
Kingwood, TX 77339-4412
Phone
(281) 359-3223
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00733 TX Primary

Addresses

Primary practice location

22999 Highway 59 N
Suite 272
Kingwood, TX 77339-4412

Mailing address

PO Box 2432
Dept 02
Houston, TX 77252-2432
Phone (281) 359-3223

Other identifiers 1

IdentifierTypeStateIssuer
00GT99OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120926000034 TX Practitioner - Physician Assistant 5597914135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Krishna V.R. Sunkureddi, M.D.,P.a.Group PAC ID 3274592209, 2 clinicians

Practice addresses (Care Compare)

11 Twin Greens CT
Kingwood, TX 77339-5323

855 Rockmead Dr
Suite 301
Kingwood, TX 77339-2102

855 Rockmead Dr
Suite 301
Kingwood, TX 77339-3300
Phone (281) 358-0502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00733TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Houston Emergency Physicians Association Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1629080569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2432",
            "address_2": "DEPT 02",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772522432",
            "telephone_number": "281-359-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22999 HIGHWAY 59 N",
            "address_2": "SUITE 272",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394412",
            "telephone_number": "281-359-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TAZ",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00GT99",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.